Effects of a repetitive gaming intervention on upper extremity impairments and function in persons with chronic stroke: a preliminary study

Abstract

Purpose: The purpose of this study was to examine the feasibility and effects of an upper extremity gaming system on impairments, activity and participation restrictions in persons with chronic stroke. Method: Nine participants with chronic (5.4 SD 3 years after stroke) upper extremity impairment due to stroke completed 18 sessions over 6 weeks with the Hand Dance Pro™ gaming system that included trunk restraint. Measures collected at pretest and posttest included three-dimensional motion analysis of paretic upper extremity reaching, Wolf Motor Function Test (WMFT) and Stroke Impact Scale (SIS). Data were analyzed across time, with effect sizes (Cohen’s d), and by categorizing participants with Fugl-Meyer Upper Extremity Motor Assessment scores (mild >50/66, moderate 26–50/66 and severe <26/66). Results: Statistically, significant improvements and medium-to-large effect sizes from pretest to posttest were found with ipsilateral reaching kinematic outcomes of movement duration, mean velocity and elbow excursion (p < 0.05). Participants with mild impairment demonstrated the greatest change in elbow excursion. No significant differences and small effect sizes were found for the WMFT and SIS. Conclusion: The gaming intervention with high repetitions of reaching to targets and trunk restraint was feasible and led to improvements in upper extremity movement kinematics in this group of participants with chronic stroke.

Implications for Rehabilitation

• Persons with chronic stroke can tolerate a high number of repetitions (between 800 and 2000) of reaching for targets during 30 minutes of playing a video game.

• Gaming systems that incorporate multiple repetitions of reaching for targets with trunk restraint can improve movement patterns in the paretic upper extremity of persons with chronic stroke.

Keywords::

• Gaming
• reaching
• stroke
• upper extremity

Acknowledgement

Special thanks to Jason Meier from C’motion, Inc. of Indianapolis for his assistance with the gaming platform and software used in this study.

Declaration of Interest: This study was supported by a Lilly Endowment Inquery Collaborative Grant from the University of Indianapolis.